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General Thoracic and Cardiovascular Surgery

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01-12-2015 | Original Article

The relationship between perioperative administration of inhaled corticosteroid and postoperative respiratory complications after pulmonary resection for non-small-cell lung cancer in patients with chronic obstructive pulmonary disease

Authors: Keiji Yamanashi, Satoshi Marumo, Tsuyoshi Shoji, Takamasa Fukui, Ryota Sumitomo, Yosuke Otake, Minoru Sakuramoto, Motonari Fukui, Cheng-Long Huang

Published in: General Thoracic and Cardiovascular Surgery | Issue 12/2015

Abstract

Objectives

Inhaled corticosteroid (ICS) treatment has been shown to increase the risk of respiratory complications in patients with stable chronic obstructive pulmonary disease (COPD). However, the effects of perioperative ICS treatment on postoperative respiratory complications after lung cancer surgery have not been elucidated. The aim of this study was to investigate whether perioperative ICS treatment would increase the risk of postoperative respiratory complications after lung cancer surgery in patients with COPD.

Methods

We retrospectively analyzed 174 consecutive COPD patients with non-small-cell lung cancer (NSCLC) who underwent lobectomy or segmentectomy between January 2007 and December 2014. Subjects were grouped based on whether or not they were administered perioperative ICS treatment. Postoperative cardiopulmonary complications were compared between the groups.

Results

There were no statistically significant differences in the incidence of postoperative respiratory complications (P = 0.573) between the perioperative ICS treatment group (n = 16) and the control group (n = 158). Perioperative ICS treatment was not significantly associated with postoperative respiratory complications in the univariate or multivariate analysis (odds ratio [OR] = 0.553, 95 % confidence interval [CI] = 0.069–4.452, P = 0.578; OR = 0.635, 95 % CI = 0.065–6.158, P = 0.695, respectively). Kaplan–Meier analysis showed that there were no statistically significant differences in the postoperative respiratory complications-free durations between the groups (P = 0.566), even after propensity score matching (P = 0.551).

Conclusion

There was no relationship between perioperative ICS administration and the incidences of postoperative respiratory complications after surgical resection for NSCLC in COPD patients.

Jen R, Rennard SI, Sin DD. Effects of inhaled corticosteroids on airway inflammation in chronic obstructive pulmonary disease: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2012;7:587–95.PubMedCentralPubMed

Sugiura H, Ichinose M, Yamagata S, Koarai A, Shirato K, Hattori T. Correlation between change in pulmonary function and suppression of reactive nitrogen species production following steroid treatment in COPD. Thorax. 2003;58:299–305.PubMedCentralCrossRefPubMed

Sin DD, McAlister FA, Man SF, Anthonisen NR. Contemporary management of chronic obstructive pulmonary disease: scientific review. JAMA. 2003;290:2301–12.CrossRefPubMed

Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J. 2009;34:380–6.CrossRefPubMed

Yamada Y, Sekine Y, Suzuki H, Iwata T, Chiyo M, Nakajima T, et al. Trends of bacterial colonisation and the risk of postoperative pneumonia in lung cancer patients with chronic obstructive pulmonary disease. Eur J Cardiothorac Surg. 2010;37:752–7.CrossRefPubMed

Sekine Y, Behnia M, Fujisawa T. Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer. 2002;37:95–101.CrossRefPubMed

Belda J, Cavalcanti M, Ferrer M, Serra M, Puig de la Bellacasa J, Canalis E, et al. Bronchial colonization and postoperative respiratory infections in patients undergoing lung cancer surgery. Chest. 2005;128:1571–9.CrossRefPubMed

Duque JL, Ramos G, Castrodeza J, Cerezal J, Castanedo M, Yuste MG, et al. Early complications in surgical treatment of lung cancer: a prospective, multicenter study. Grupo Cooperativo de Carcinoma Broncogenico de la Sociedad Espanola de Neumologia y Cirugia Toracica. Ann Thorac Surg. 1997;63:944–50.CrossRefPubMed

Turner MO. Inhaled corticosteroids and pneumonia in COPD: an association looking for evidence. Am J Respir Crit Care Med. 2008;177:555–6 (author reply 556).CrossRefPubMed

10.

Drummond MB, Dasenbrook EC, Pitz MW, Murphy DJ, Fan E. Inhaled corticosteroids in patients with stable chronic obstructive pulmonary disease: a systematic review and meta-analysis. JAMA. 2008;300:2407–16.CrossRefPubMed

11.

Woodhead M. Inhaled corticosteroids cause pneumonia…or do they? Am J Respir Crit Care Med. 2007;176:111–2.CrossRefPubMed

12.

Ernst P, Gonzalez AV, Brassard P, Suissa S. Inhaled corticosteroid use in chronic obstructive pulmonary disease and the risk of hospitalization for pneumonia. Am J Respir Crit Care Med. 2007;176:162–6.CrossRefPubMed

13.

Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347–65.CrossRefPubMed

14.

Nojiri T, Inoue M, Yamamoto K, Maeda H, Takeuchi Y, Funakoshi Y, et al. B-type natriuretic Peptide as a predictor of postoperative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer. Ann Thorac Surg. 2011;92:1051–5.CrossRefPubMed

15.

Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med. 2007;356:775–89.CrossRefPubMed

16.

Burge PS, Calverley PM, Jones PW, Spencer S, Anderson JA, Maslen TK. Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disease: the ISOLDE trial. BMJ. 2000;320:1297–303.PubMedCentralCrossRefPubMed

17.

Whitford H, Orsida B, Kotsimbos T, Pais M, Ward C, Zheng L, et al. Bronchoalveolar lavage cellular profiles in lung transplantation: the effect of inhaled corticosteroids. Ann Transplant. 2000;5:31–7.PubMed

18.

van Rensen EL, Straathof KC, Veselic-Charvat MA, Zwinderman AH, Bel EH, Sterk PJ. Effect of inhaled steroids on airway hyperresponsiveness, sputum eosinophils, and exhaled nitric oxide levels in patients with asthma. Thorax. 1999;54:403–8.PubMedCentralCrossRefPubMed

19.

Tinkelman DG, Bronsky EA, Gross G, Schoenwetter WF, Spector SL. Efficacy and safety of budesonide inhalation powder (Pulmicort Turbuhaler) during 52 weeks of treatment in adults and children with persistent asthma. J Asthma. 2003;40:225–36.CrossRefPubMed

20.

Kew KM, Seniukovich A. Inhaled steroids and risk of pneumonia for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2014;3:CD010115.PubMed

21.

Decramer ML, Hanania NA, Lotvall JO, Yawn BP. The safety of long-acting beta2-agonists in the treatment of stable chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2013;8:53–64.PubMedCentralCrossRefPubMed

22.

Jeon JH, Kang CH, Kim HS, Seong YW, Park IK, Kim YT, et al. Video-assisted thoracoscopic lobectomy in non-small-cell lung cancer patients with chronic obstructive pulmonary disease is associated with lower pulmonary complications than open lobectomy: a propensity score-matched analysis. Eur J Cardiothorac Surg. 2014;45:640–5.CrossRefPubMed

Title: The relationship between perioperative administration of inhaled corticosteroid and postoperative respiratory complications after pulmonary resection for non-small-cell lung cancer in patients with chronic obstructive pulmonary disease
Authors: Keiji Yamanashi
Satoshi Marumo
Tsuyoshi Shoji
Takamasa Fukui
Ryota Sumitomo
Yosuke Otake
Minoru Sakuramoto
Motonari Fukui
Cheng-Long Huang
Publication date: 01-12-2015
Publisher: Springer Japan
Published in: General Thoracic and Cardiovascular Surgery / Issue 12/2015
Print ISSN: 1863-6705
Electronic ISSN: 1863-6713
DOI: https://doi.org/10.1007/s11748-015-0593-0

At a glance: The STEP trials

Springer Medicine

The relationship between perioperative administration of inhaled corticosteroid and postoperative respiratory complications after pulmonary resection for non-small-cell lung cancer in patients with chronic obstructive pulmonary disease

Abstract

Objectives

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

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